Long-Term Use of Bone Drugs May Be Linked to Esophageal Cancer

5 years of meds such as Boniva, Fosamax almost doubles chances, but actual risk still low, researchers say

By Steven Reinberg
HealthDay Reporter

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THURSDAY, Sept. 2 (HealthDay News) -- People with osteoporosis who take drugs such as Boniva (ibandronate), Fosamax (alendronate) or Actonel (risedronate) to strengthen their bones may be at an increased risk of esophageal cancer, British researchers report.

This class of medicines, called oral bisphosphonates, are the most commonly used drugs to treat osteoporosis and other bone diseases. While anecdotal reports have suggested that they may increase the risk of esophageal cancer, the scientific evidence has been limited, the researchers noted.

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"What we lack at present is a full picture of the benefits versus risks for long-term use of bisphosphonates, which are increasingly commonly prescribed," said lead researcher Dr. Jane Green, a clinical epidemiologist, in the Oxford University's Cancer Epidemiology Unit. "Our results are a small part of this picture."

There are no immediate implications for clinical practice, Green stressed.

"Esophageal cancer is uncommon, and even if risk is doubled it is still low" for any one person, she said.

Also, "like any observational study, we cannot be sure that the results reflect a true effect of the drugs -- it could be that people more likely to get cancer are prescribed bisphosphonates [more often] -- although we accounted for the major known possibilities. As usual, more research is needed," Green said.

The report is published in the Sept. 2 online edition of the BMJ.

In the study, Green's team used the UK General Practice Research Database to collect data on almost 3,000 men and women with esophageal cancer, more than 2,000 with stomach cancer and over 10,000 with colorectal cancer diagnosed between 1995 and 2005.

They compared these patients with age- and sex-matched people without these conditions.

The team found people who had had 10 or more prescriptions for bisphosphonates written for them, or had received prescriptions for these drugs over about five years, had almost double the risk of esophageal cancer, compared with people who didn't take these drugs.

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